Exploring Pharmacists’ Role in a Changing Healthcare ...

1 Exploring pharmacists Role in a Changing Healthcare Environment 1 Exploring pharmacists Role in a Changing Healthcare EnvironmentMay 2014 Prepared by:Avalere Health LLC Exploring pharmacists Role in a Changing Healthcare Environment 2 TABLE OF CONTENTSE xecutive Summary 3 Introduction 6 Approach 8 Examining the Published Evidence 9 Table 1.

2 Definitions and Examples of Current Practice for Pharmacist Services 11 Exploring the Role of Pharmacist Services 13 Pharmacist-provided Medication Management 13 Pharmacist-provided Medication Reconciliation 15 Pharmacist-provided Preventive Care Services (Screening and Immunization) 17 Pharmacist-provided Education and Behavioral Counseling 19 Collaborative Care Models 20 Conclusions 22 References 23 Funding for this research was provided by.

3 American pharmacists Association (APhA)American Society of Health-System pharmacists (ASHP)American Association of Colleges of Pharmacy (AACP)American Society of Consultant pharmacists (ASCP)National Association of Chain Drug Stores (NACDS)National Alliance of State Pharmacy Associations (NASPA)Avalere Health maintained full editorial control and the conclusions expressed here are those of the pharmacists Role in a Changing Healthcare Environment 3 EXECUTIVE SUMMARYOver the last several years, the Healthcare environment has seen a great deal of change. As unsustainable Healthcare costs persist, stakeholders are ever more focused on value.

4 Increases in Healthcare costs have typically not resulted in improvements in quality, and may be related to inefficiencies and variation in care delivery. At the same time, there is a corresponding expansion of information both in the way evidence is generated and in the way it is stored and shared that is poised to facilitate quality improvement, cost savings, and collaboration among providers. In this environment, three related trends are shaping the market today:1) Health plans are seeking savings through more cost-effective benefits, partner-ships and integration, and increased risk-sharing arrangements with providers.

5 2) Providers are focused on delivering higher value services, with an increased appreciation of coordinated care and an interdisciplinary team approach that extends beyond institutional walls. 3) Patients are becoming more engaged Healthcare consumers as a result of better access to their own health information, transparency of health plan and provider ratings, and greater exposure to the true costs of value imperative requires a clear understanding of how each type of Healthcare provider can contribute to more cost-effective patient care. This white paper focuses on understanding the types of services that pharmacists can provide, and how a shifting landscape may affect the demand for these services in the future.

6 Role of pharmacists Historically, pharmacists role in Healthcare centered around dispensing medications in accordance with a prescription, and providing a final check to ensure accurate delivery of medications to patients. Although they receive training in preventive care, health and wellness, and patient education, pharmacists have traditionally leveraged their clinical knowledge to review prescribed drug regimens to prevent inappropriate dosing and minimize drug interactions. pharmacists roles have expanded over time to include more direct patient care, such as primary care and disease management services, and their roles continue to evolve today.

7 Now more than ever, team-based Healthcare is gaining traction in the United States. As pharmacists continue to collaborate as part of a patient s team of providers, it is important to understand the types of services they provide, their capacity to mean-ingfully improve care and, ultimately, how these services can align with the Changing Healthcare environment. To that end, we have sought to carefully explore evidence on pharmacist services through a structured literature review of systematic reviews and recently published primary research articles to consider how these services might Exploring pharmacists Role in a Changing Healthcare Environment 4be deployed in patient care.

8 To focus this assessment, we identified a set of four key pharmacist services and one care delivery arrangement discussed in the most recent primary research articles published in the United States: medication management; medication reconciliation; preventive services (screening and immunization); education and behavioral counseling; and collaborative care of Key FindingsThe evidence base on pharmacist services is growing and spans multiple therapeutic areas and settings including community pharmacies, physician offices, ambulatory/ outpatient clinics, inpatient settings, and long-term care (LTC) settings.

9 Many of the pharmacist services explored in this paper have been shown to improve therapeutic out-comes, adherence to medications, or reduced downstream Healthcare costs, as follows: Because accountable care organizations (ACOs) manage the entirety of care for a patient, they may look to integrate pharmacist-provided medication management to improve medication adherence and clinical outcomes, while potentially reducing costs. Medication management conducted by pharmacists has been shown to improve medication adherence and clinical outcomes for patients with chronic diseases such as diabetes, hypertension, cardiovascular disease, and hyperlip-idemia, among Some recent research also has indicated that pharmacist-provided medication management can be cost saving,5,10-12 and more contemporary evidence on these services within evolving delivery systems will further inform stakeholders.

10 Pharmacist-provided medication reconciliation can help reduce medication discrepancies and may be an important component of improving transitions of care moving forward. Pharmacist-provided medication reconciliation can detect and reduce medi-cation discrepancies, and can reduce related adverse drug events and/or subsequent Healthcare Comprehensive transitions of care programs that utilize pharmacist-provided medication reconciliation will be especially important in the post-hospital discharge setting for patients at elevated risk of rehospitalization.